by Helen Knight:
During Yale’s 2011 Global Health Leadership Institute Conference, I observed participants discuss health system issues. In the past week since the conference ended, I’ve thought considerably about the challenges the participants face.
The conference agenda centered on a challenge: delegations were asked to use strategic problem solving methods to address health issues in their countries (Ethiopia, Ghana, Liberia, Rwanda, and South Africa). For instance, the six participants from South Africa examined limited progress in reducing maternal, newborn, and child deaths. They developed a strategy around the theory that improving health sector leadership capacity can improve clinical outcomes for these issues. As they said, “We must make it possible for health workers to have the self-confidence to solve their own problems.”
The larger challenge lies ahead—in the participants’ implementation of their strategies. They will have to find time to devote to this project, and many have responsibilities in health ministries and hospitals. They will need to communicate with each other, even though they live in different regions of their countries. They will have to engage invested parties, and find the financial and human resources to realize their plans.
A year from now, the 2012 GHLI Conference will take place. At that time, participants will discuss implementation progress. Without question, delegations will return to New Haven having fallen short of their ambitions.
But falling short is not shameful—in fact, it may allow delegations to both teach and learn more at the conference. I was struck by the communication between different countries. The participants came from hugely different backgrounds—for example, the number of people living with HIV/AIDS in South Africa is larger than the total population of Liberia. In Ghana, the mortality rate due to malaria is almost twice that in Rwanda. Still, their discourse revealed that similar issues concerned them all, such as maintaining health workers’ motivation, preventing brain drain, garnering political support, and disseminating best practices. These issues facilitated inter-country learning. Commonalities cultivated a sense of solidarity: in the words of Rwanda’s Dr. Patrick Kyamanywa, “[There was] an openness, an environment of mutual respect.”
If this culture of communication develops at next year’s conference, then it will be useful to all—regardless of what progress has been made. In the next twelve months, participants will be challenged to achieve specific goals. But at least as importantly, they will be challenged to understand and to be able to articulate why goals were met, or why they were not.